Abstracts of the 4th Biennial Schizophrenia International Research Conference / Schizophrenia Research 153, Supplement 1 (2014) S1–S384 S159

working memory test (n=102 cases) and attention. (n=121 cases). The time

required for administration of the MATRICS battery was on average 67

minutes and the time required for analysies of scores and classificaon 45

minutes. Individuals with classified as having congitive impairment had

more greater severity of negative symptoms, and were slightly older than

those without congitive impairment. Useing the Cognigram system, 162

cases of congitive impairment were classified in the schizophrenia sample

with an agreement in classification of 94%. Time for admonoistraiton of the

Cognigram system was 15 minutes and scoring was immediate.

Discussion: These data suggest that it is possible to use a small battery of

cognitive tests to identify the prsence of congitive impairment in indiviual

patients with schizophrenia. Use of the Cognigram system to identify cogni-

tive impairment provided a high degree wof agreement with conventional

neuropsychological testing and analysis, yet was completed in much less

time. Screening for congitive impairment in schizophrenia may be kimpor-

tant for identifying people who would benefit from treatment with putative

cognitive enhancing drugs

Poster #S191

THE CHICKEN OR THE EGG? – AN INVESTIGATION OF COGNITIVE AND

NON-COGNITIVE IMPAIRMENTS IN SCHIZOPHRENIA IN THE LIGHT OF

GOAL-DIRECTED BEHAVIOURS’ IMPLEMENTATION

Rinaldi Romina1,2, Lefebvre Laurent3

1Neuropsychology; 2Cognitive Sciences; 3UMONS

Background: For 20 years, deficits of goal-directed behaviours (GDB) have

been considered a key feature in schizophrenia. GDB refer to behaviours

generated following a given objective by building a plan and selecting

actions. These actions should lead to the attended goal either immediately

or within a longer period. These types of actions are involved in most

of the complex or novel situation a subject may encounter, regardless

of the cognitive, affective or social abilities this situation implies. Yet so

far, few studies have attempted to investigate the clinical impact of these

disorders. There is clearly a wide range of investigations in the field of the

medical imagery; however, they do not capture the important relevance

of these disorders in understanding cognitive and behavioural deficits in

schizophrenia. Our study aims to address the question of GDB impairments

from a clinical angle by investigating how constraints and instructions can

impact the subject’s performances in cognitive and visuomotor tasks.

Methods: 50 to 100 in- and outpatients are currently assessed with two

programs: one using verbal fluency (semantic and letter fluencies), and the

other using a visuomotor task (in which subjects have to hit targets on a

touch screen). Those programs are built so as to vary the conditions for

carrying out the task from the freer to the most constrained. To do so,

in both of the tasks, the subjects have to complete a free condition task

(“do however they want”) and then they are given contextual cues that are

either words (for the verbal fluency) or instructions (for the visuomotor

task) which are supposed to structure their responses. Three conditions

are then proposed: one free, one fully cued (structured) and one with

less directive or indirect cues (semi-structured). Besides, anamnestic (age,

sex, schooling), clinical (PANSS, BPRS, LARS, neuroleptic dose, additional

treatment and duration of illness) and cognitive (mental flexibility, inhi-

bition, attentional shifting, sustained attention and verbal IQ) features are

considered.

Results: Preliminary data on 20 subjects (10 men and 10 women; age:

44±10.98; schooling: 10.8±1.79 school years completed) show that in ver-

bal fluency, patients benefit from the structuring procedures in semantic

fluency (number of words produced) as much as cueing is strong (struc-

tured fluency>classic fluency**; semi-structured fluency>classic fluency*);

but also in letter fluency (structured fluency>classic fluency**) in which

cues also help subjects in organizing their responses (clusters in struc-

tured letter fluency>clusters in classic letter fluency**). Results display

the same pattern for the visuomotor task (number of hits) (structured

condition>semi-structured condition>free condition**). Finally, among all

the anamnestic, clinical and cognitive controlled features, only mental flex-

ibility significantly correlates with the ability to benefit from cueing in the

verbal, but also in the visuomotor task.

Discussion: Preliminary data show that patients could benefit from cueing

in cognitive and visuomotor tasks in terms of efficiency but also in terms of

responses organization, regardless of their anamnestic, cognitive or clinical

profile. This suggests that both cognitive and non-cognitive impairments

found in a wide range of abilities in patients with schizophrenia could

be underlined by the same deficit mechanism in the implementation of

goal-directed behaviours; which could be offset by structuring procedures.

Results of the entire sample (including subjects with schizophrenia and a

control group) will be presented and the specific nature of the impaired

mechanism (initiation versus planning) will be discussed. *p<0.05 **p<0.01

Poster #S192

EXAMINING THE IMPACT OF NEUROCOGNITIVE AND LANGUAGE

IMPAIRMENTS ON FORMAL THOUGHT DISORDER IN SCHIZOPHRENIA

Eric Tan1, Gregory Yelland1, Susan Rossell2

1Monash University; 2Brain and Psychological Sciences Research Centre,

Swinburne University

Background: Formal thought disorder (FTD) in schizophrenia has been

associated with both cognitive and language impairments. However, there

is still considerable debate regarding the degree to which each contributes

to FTD. There has also been evidence that neurocognition is related to

language processing abilities (Bagner et al., 2003). In this study, we chose

to focus on receptive language impairments in schizophrenia. In particular,

we investigated receptive language impairments at both the single word

and sentence levels. This study had two aims: (i) to examine which cog-

nitive impairments are related to FTD and, (ii) to explore if FTD has any

language-specific symptoms, independent of neurocognition.

Methods: 9 schizophrenia/schizoaffective patients with diagnosed FTD, 48

schizophrenia/schizoaffective disorder patients without diagnosed FTD and

48 healthy controls completed the MATRICS battery and D-KEFS Stroop task

assessing general neurocognition and inhibition, as well as two language

tasks assessing synonym identification (lexical semantics) and sentence

meanings (syntax). Clinical symptoms were rated using the PANSS, and FTD

was rated using the TLC (Andreasen, 1979) and PANSS P2.

Results: Cognitive assessment results revealed FTD patients performed

worse than non-FTD patients on measures of semantic and executive pro-

cessing (p<0.05), with both groups poorer than controls (p<0.01). This

supports indications of concurrent semantic and executive dysfunction, and

suggests that a combination of both may relate to manifest FTD. Language

assessment results revealed impairments in FTD compared to non-FTD

patients and controls in the recognition of homophones (but not antonyms)

and sentence comprehension (syntax). This supports language processing

impairments at both the single word and sentence levels in FTD. A signif-

icant relationship between positive FTD symptoms and syntactic problems

(p<0.001) was found to hold even after controlling for neurocognitive

deficits (semantic and executive). The relationship between FTD and homo-

phone choice did not hold. This provides evidence that a language-specific

impairment of syntactic ability is present in schizophrenia, and exacerbated

in FTD.

Discussion: Overall, this study supports current cognitive and language

theories of impairment in FTD, with evidence for concurrence of both. Syn-

tactic impairments reflect a specific deficit in language processing; which

contribute to FTD severity in combination with executive and semantic

dysfunction.

Poster #S193

SOCIAL COGNITION TRAINING FOR PEOPLE WITH SCHIZOPHRENIA:

A RANDOMISED STUDY

Matteo Cella1,2, Rumina Taylor2, Emese Csipke2, Charles Heriot-Maitland2,

Til Wykes1

1Department of Psychology, Institute of Psychiatry, Kings College London;2King’s College London

Background: Social functioning deficits are common in people with

schizophrenia and were shown to be important prognostic indicators.

Social Cognition and Interaction Training (SCIT) is a manual-based treat-

ment designed to improve social functioning in people with schizophrenia

by enhancing social cognition. The aim of this study was to evaluate the

feasibility, acceptability, and efficacy of SCIT in male inpatient forensic

wards.

S160 Abstracts of the 4th Biennial Schizophrenia International Research Conference / Schizophrenia Research 153, Supplement 1 (2014) S1–S384

Methods: The study is a randomised single blind controlled, crossover

design, with 21 participants randomised to SCIT and 15 to treatment as

usual (TAU). SCIT treatment consisted of eight-week therapy sessions twice

per week. Participants were assessed before and after the intervention

period with measures of symptoms, affect recognition, theory of mind

and attributional style. Feasibility was assessed through group attendance.

Participant acceptability was evaluated through post-group satisfaction and

social goals achievement.

Results: The group was well received by all participants and the majority

reported their confidence had improved following the intervention. Almost

two thirds of the SCIT participants agreed they had achieved their social

goal as a result of the intervention. Participants in the SCIT group showed a

significant improvement in affect recognition compared to TAU. However,

the two groups did not differ in theory of mind and attributional style after

therapy.

Discussion: It is feasible to deliver SCIT in forensic ward setting and the

intervention improved affect recognition. Some adaptations may be needed

in order to accommodate for the reduced social contact of forensic wards.

Poster #S194

ROLL-OUT AND IMPACTS OF DJ’S CHOICES WORKSHOPS

Marie-france Demers1,2, Julie Bourbeau1, Claudia Lévesque1,

Lysanne Gauthier1, Marc-André Roy3,1

1Institut universitaire en santé mentale de Québec; 2Centre de recherche de

l’Institut universitaire en santé mentale de Québec; 3Université Laval

Background: Since 2010, in Quebec province, several teams are familiar

with the DJ’s Choices program to promote treatment adherence in pa-

tients suffering from psychosis. In addition to a short introduction to the

program, these teams have expressed a need for support and training to

embrace an interdisciplinary approach combining psychosocial and medical

perspectives. The goal of our communication is to describe our multicenter

project that will assess the impact of DJ’s Choices approach roll-out in

different settings. This project therefore pursues the following objectives:

1) To ensure the roll-out of DJ’s Choices workshops in their current format

as resources for specialized and primary care teams. This means organizing

and supporting the roll-out of such a program for teams caring for people

with mental illness, including specialized and primary care teams from

a representative selection of facilities within the Québec province; 2) To

assess the impact of the distribution of this program on patients, care

providers and the organization, using treatment adherence indicators in

exposed individuals and satisfaction, skill enhancement and cross-sharing

indicators in professionals involved in implementation.

Methods: The roll-out of DJ’s Choices workshops will rely on INSPQ (Institut

national de santé publique du Québec) theoretical model for knowledge

transfer, including its eight stages (production/co-production of the support

and training program content, program adaptation, distribution, reception,

adoption, appropriation, use of knowledge and assessment of results). A

first qualitative phase will be conducted through an initial telephone sur-

vey of key players (care providers already exposed to the program and

individuals targeted to receive training) using a set questionnaire. Analysis

of this data will provide a basis for creating a program targeting training

and support for the DJ’s Choices workshops roll-out. A roll-out kit will then

be developed to support DJ’s kit deployment in these identified settings

Results: The impacts observed in care providers and individuals living with

psychosis exposed to the program will be assessed before, during and after

the program over a 3 years period. Nine sites will be included, some from

university clinics, others, from community settings in the Quebec province.

Several indicators of impact will be collected at three main levels: 1) In

patients: Combined assessment measures for adherence (e.g., self-report

adherence scales, prescription renewal at the pharmacy, overall clinical

assessment according to care providers’ impressions, medication counting

where possible) will be collected before, during and after program roll-out.

2) In health care providers: basic knowledge concerning psychopharma-

cology and facilitation techniques inspired by the motivational approach

and cognitive behavioral therapy will be assessed throughout the three

stages of the project. 3) In organizations: We will carefully describe the

different organizational environments in which the program will roll out

and will identify the factors that promote or restrict program roll-out in

the different settings

Discussion: This project will include systematic assessment of the im-

pacts of the DJ’s Choices roll-out in a representative sample of different

psychiatric care settings in Quebec. In the long term, it aims to improve

the efficiency of the distribution of this innovative treatment adherence

support to all settings in the province

Poster #S195

PREVENTION OFWEIGHT GAIN IN EARLY PSYCHOSIS: A RANDOMIZED

CONTROLLED CLINICAL TRIAL OF 16-WEEK STEPPED BEHAVIORAL

INTERVENTION

Rohan Ganguli1,2, Sabrina Hassan3, Mehreen Bhamani3, Todd Jenking3

1Psychiatry; 2Professor of Psychiatry, University of Pittsburgh; 3CAMH

Background: Patients with serious mental disorders are at higher risk of

being overweight and obese which increases their vulnerability to cardio-

vascular morbidities and mortalities. Along with unhealthy dietary habits

and higher physical inactivity in patients with psychosis, the use of novel

antipsychotic drugs is highly associated with weight gain especially in

early phase of treatment. The degree of weight gain varies by the type

of antipsychotic medications being used, with clozapine and olanzapine

are most likely to cause weight gain, followed closely by risperidone and

quetiapine. The higher prevalence of obesity in patients receiving anti-

psychotic treatment, directs our attention towards developing strategies to

reduce weight gain in this high risk group. The aim of the study therefore,

was to evaluate whether a “stepped behavioral intervention” is effective in

preventing weight gain in early psychotic patients as compared to usual

care.

Methods: This was a parallel group randomized control trial (RCT) in which

sixty participants diagnosed with an early psychotic illness (schizophrenia,

schizoaffective disorder, bipolar disorder, psychosis NOS, within 5 years

of illness-onset) were recruited for a 16-week intervention program. After

providing informed consent, the participants who met the enrollment crite-

ria were randomly assigned to either get a stepped behavioral intervention

(SBI) (n∼30) or treatment as usual (TAU) (routine care, n∼30). The preven-

tion of weight gain (increase over baseline) in two groups, using chi-square

test, was the primary outcome measure, with mean change in weight as a

secondary outcome (t test).

Results: Sixty two percent of the participants were male, most were single

and young with a mean age of 24.5 + 5.8 years. Fifty five percent of the

participants were of European ancestry followed by 22% of African ancestry.

Only 4 of the participants were employed. Out of 60 participants, regardless

of treatment assignment, 12 did not gain any weight. And of these 83%

were in SBI group as compared to only 17% in the control group (P value =

0.034). The mean change in weight was 2.27 + 4.7 in SBI group and 4.61 +

4.6in TAU group (P value= 0.08). Further, all participants gaining more than

20% over baseline weight were in the TAU group. Overall, the participants in

the SBI were significantly less likely to gain weight and their mean weight

gain was also lower (approaching significance) than for the TAU group.

Discussion: The findings of our study have important public health im-

plications. Weight gain in early psychosis, partly associated with the use

of antipsychotic medications make the psychotic individual vulnerable to

obesity related complications which may lead to inferior quality of life

and decrease life expectancy. The SBI, evaluated in this clinical trial, shows

promise in preventing weight gain in these individuals with a serious

mental disorder. Such interventions not only increase the awareness about

the benefits of healthy life style but also motivate the patients to adopt

them as part of their daily routine. Numerous studies of patients with

chronic illness and established obesity have demonstrated that behavioral

interventions can be effective in inducing weight loss. However, prevention

of weight gain is likely to be even more effective in reducing the risk of

both diabetes and cardiovascular diseases in this population, and to also

more effectively reduce disability and premature mortality.